Catheter securement device

ABSTRACT

A catheter securement device holds a medical article such as a catheter hub or a connector fitting in position upon the body of a patient and at least inhibits longitudinal movement of the medical article. The securement device includes a retainer and at least one anchor pad. The retainer forms a central channel into which at least a portion of the medical article is inserted. The retainer includes at least one abutment that can abut against a contact point or surface on the medical article. The abutment, in conjunction with a second abutment and/or a tapering shape of the central channel, inhibits motion of the medical article in proximal and distal directions through the central channel. For this purpose, the abutment surface(s) can lie either within or outside the channel.

RELATED APPLICATIONS

[0001] This application claims priority under 35 U.S.C. § 119(e) to U.S.Provisional Patent Application Serial Nos. 60/404,354 (filed Aug. 15,2002), 60/411,127 (filed Sep. 16, 2002), 60/414,999 (filed Sep. 30,2002), 60/418,389 (filed Oct. 11, 2002), and 60/454,430 (filed Mar. 11,2003), all of which are hereby expressly incorporated by reference intheir entireties.

BACKGROUND OF THE INVENTION

[0002] 1. Field of the Invention

[0003] This invention relates to a securement system used to attach amedical line to a patient.

[0004] 2. Description of the Related Art

[0005] It is common in the treatment of patients to utilize catheters tointroduce fluids and medications directly into the patient or towithdraw fluids from the patient. Often, it becomes desirable tomaintain such catheterization over an extended period of time during thetreatment of a patient. In order to keep the catheter or other medicalline properly positioned for the duration of treatment, the catheter ormedical line can be secured to the patient in a variety of ways. Mostcommonly, this involves taping the catheter or medical line to thepatient.

[0006] Securing a catheter with tape upon the patient traditionally hascertain drawbacks. The use of tape at the insertion site can retain dirtor other contaminant particles, potentially leading to infection of thepatient. Tape also fails to limit catheter motion and, therefore,contributes to motion related complications like phlebitis, infiltrationand catheter migration. Additionally, removal of taped dressings canitself cause undesired motion of the catheter upon the patient.

[0007] Taped dressings also require periodic changes. The frequent,often daily, removal and reapplication of adhesive tape to the skin ofthe patient can excoriate the skin in the area around the dressing. Suchrepeated applications of tape over the catheter or medical line canadditionally lead to the build up of adhesive residue on the outersurface of the catheter or medical line. This residue can result incontaminants adhering to the catheter itself, increasing the likelihoodof infection of the insertion site. This residue can also make thecatheter or medical line stickier and more difficult to handle forhealthcare providers.

SUMMARY OF THE INVENTION

[0008] The systems and methods of the present invention have severalfeatures, no single one of which is solely responsible for its desirableattributes. Without limiting the scope of this invention as expressed bythe claims which follow, its more prominent features will now bediscussed briefly. After considering this discussion, and particularlyafter reading the section entitled “Detailed Description of thePreferred Embodiments” one will understand how the features of thisinvention provide several advantages over traditional cathetersecurement systems.

[0009] One aspect of the present invention is a medical line securementsystem that comprises a medical article, at least one anchor padincluding a lower adhesive surface configured to attach to an epidermallayer of a patient, and a retainer. The retainer comprising a bodymember having a channel formed therethrough about a channel axis, thechannel being configured to retain at least a portion of the medicalarticle and having a longitudinal access opening disposed on anunderside of the body member to allow at least ingress of the portion ofthe medical article into the channel. The retainer further comprising atleast one abutment extending generally normal to the channel axis andconfigured to inhibit longitudinal movement of the medical article andat least one support disposed on the underside of the retainer and to aside of the access opening opposite the channel axis, the supportattached to the anchor pad.

[0010] Another aspect of the invention is a retainer configured for usewith a medical article. The retainer comprises a body member whichcomprising a channel formed through the body member, the channel beingconfigured to retain at least a portion of the medical article andhaving a longitudinal access opening disposed on an underside of thebody member to allow at least ingress of the medical article into thechannel. The body member further comprising at least one abutmentextending generally normal to an axis of the inverted channel andconfigured to inhibit longitudinal movement of the medical article andat least one support disposed on the underside of the retainer and to aside of the access opening opposite the channel axis.

[0011] Another aspect of the invention is a retainer that is configuredfor use with a medical article. The retainer comprises a body memberwhich comprises a channel formed through the body member, the channelbeing configured to retain at least a portion of the medical article andhaving a longitudinal access opening disposed on an underside of thebody member to allow ingress of the portion of the medical article intothe channel. The body member further comprising at least one abutmentextending generally normal to an axis of the channel and configured toinhibit longitudinal movement of the medical article and means forholding the medical article away from a patient's skin.

[0012] Yet another aspect of the invention is a retainer that isconfigured for use with a medical article that comprises a radiallyextending member. The retainer comprises a body member having proximaland distal ends and further comprises a channel formed through the bodymember, the channel being configured to retain at least a portion of themedical article and having a longitudinal access opening disposed on anunderside of the body member to allow at least ingress of the medicalarticle into the channel. The body member further comprises at least oneslot disposed between the proximal and distal ends of the body memberand configured to receive the radially extending member and a stopmember extending into a portion of the at least one slot such that whenthe medical article is inserted into the channel and rotated in a firstdirection around the axis of the channel, the radially extending memberslides within the slot until the radially extending member contacts thestop member.

[0013] Another aspect of the invention is a method of securing a medicalarticle to a patient. The method comprises providing a medical article,providing a retainer having a channel formed therethrough, the channelbeing configured to receive and retain the medical article, and at leastone abutment extending generally normal to the channel, and positioningthe retainer over the medical article. The method further comprisespressing the medical article into the channel through an opening formedon the underside of the retainer, abutting the medical article againstthe abutment to inhibit longitudinal motion of the medical articlerelative to the retainer in at least one direction, and after pressingthe article into the body member, adhering the retainer relative to apatient's skin.

[0014] Still another aspect of the invention is a medical linesecurement system that comprises a medical article having a connectorand a retainer. The retainer comprises a body member having a channelformed therethrough, the channel being configured to retain at least aportion of the medical article and having a longitudinal access openingdisposed on an underside of the body member to allow ingress of theportion of the medical article into the channel and at least oneabutment extending generally normal to an axis of the channel andconfigured to inhibit longitudinal movement of the medical article. Theretainer further comprises at least one support surface disposed on theunderside of the retainer and to a side of the access opening oppositethe channel axis and wherein an overall length of the retainer is lessthan a length of the medical article.

[0015] A further aspect of the invention is a retainer configured foruse with a medical article. The retained comprises a body member whichcomprises a channel formed therethrough, the channel being configured toretain a portion of the medical article and having a longitudinal accessopening disposed on an underside of the body member to allow ingress ofthe medical article into the channel. The body member further comprisingat least one abutment extending generally normal to an axis of thechannel and configured to inhibit longitudinal movement of the medicalarticle and at least one support disposed on the underside of theretainer and to a side of the access opening opposite the channel axis,wherein a distance between the at least one support and the axis- of thechannel prevents contact between the medical article and a patient'sskin when the retainer is placed upon the patient's skin.

[0016] A still further aspect of the invention is a retainer configuredfor use with a medical article. The retainer comprises a body memberwhich comprises a channel formed therethrough, the channel beingconfigured to retain the medical article and having a longitudinalaccess opening disposed on an underside of the body member to allowingress of the medical article. The body member further comprises atleast one abutment extending generally normal to an axis of the channeland configured to inhibit longitudinal movement of the medical articleand at least one support disposed on the underside of the retainer andto one side of the access opening opposite the channel axis, wherein thesupport surface provides a mounting surface for attachment of theretainer to a patient's skin, and wherein the mounting surface is angledrelative to the longitudinal access opening to define an incident anglebetween the axis of the channel and the patient's skin.

BRIEF DESCRIPTION OF THE DRAWINGS

[0017]FIG. 1 is a perspective view of the securement device configuredin accordance with a preferred embodiment of the present invention.

[0018]FIG. 2 is a top plan view of the securement device of FIG. 1 thatincludes a retainer and anchor pads.

[0019]FIG. 3 is a top plan view of a right anchor pad of FIG. 2.

[0020]FIG. 4 is a top plan view of a left anchor pad of FIG. 2.

[0021]FIG. 5 is a top plan view of the retainer of FIG. 2.

[0022]FIG. 6 is a front side view of the retainer of FIG. 5.

[0023]FIG. 7 is a side view of the retainer of FIG. 5.

[0024]FIG. 8 is a side view of the retainer of FIG. 5.

[0025]FIG. 9 is a cross-section view of the retainer taken along section9-9 of FIG. 5.

[0026]FIG. 10 is a cross-section view of the retainer taken alongsection 10-10 of FIG. 5;

[0027]FIG. 11 is a cross-section view of the retainer taken alongsection 11-11 of FIG. 5 and illustrates an optional wall or stop memberin the preferred embodiment that extends into the path of the one ormore slots in the region of the mounting wing 210(b).

[0028]FIG. 12 is a bottom plan view of the retainer of FIG. 5 andillustrates that the distance between the side mounting wings varies inthe region of the retainer.

[0029]FIG. 13 is a rear side view of the retainer of FIG. 5.

[0030]FIG. 14A is a perspective view of a retainer configured inaccordance with another preferred embodiment in which the invertedchannel has a tapering distal section, a generally constant sizeproximal section and an abutment surface facing distally between theproximal and distal sections of the channel.

[0031]FIG. 14B is a top plan view of the retainer of FIG. 14B andillustrates proximal and distal sections of the channel.

[0032]FIG. 15A is a perspective view of an example of a connectorfitting with a spin nut and of a catheter hub with which the securementdevice of FIG. 1 can be used.

[0033]FIG. 15B is a perspective view of the connector fitting of FIG.15A with the spin nut secured in the forward position and secured to thecatheter hub.

[0034]FIG. 16 is an exploded, perspective view of the connector fittingsecured to the catheter hub of FIG. 15B, both aligned with the anchorpad and the retainer of FIG. 1.

[0035]FIG. 17 is an exploded, perspective view of the connector fittingsecured to the catheter hub of FIG. 15B, with the catheter hub beinginserted into the retainer of FIG. 1.

[0036]FIG. 18 is a perspective view of the catheter hub secured to thesecurement device of FIG. 1.

[0037]FIG. 19 is a perspective view of a securement device configured inaccordance with another preferred embodiment of the present invention.

[0038]FIG. 20 is a perspective view of a connector fitting secured to acatheter hub, with the connector fitting having a first collar locatedbetween a second collar and a spin nut.

[0039]FIG. 21 is a perspective view of another connector fitting securedto a catheter hub, with the connector fitting having a radiallyextending tab.

[0040]FIG. 22 is an exploded, perspective view of the connector fittingand the catheter hub of FIG. 20, the collar of the connector fittingbeing aligned with the anchor pad and the retainer of FIG. 19.

[0041]FIG. 23 is an exploded, perspective view of the connector fittingand the catheter hub of FIG. 15B, the elongated body of the connectorfitting being aligned with the anchor pad and the retainer of FIG. 19.

[0042]FIG. 24 is an exploded, perspective view of the connector fittingand the catheter hub of FIG. 15B, the collars of the connector fittingbeing aligned with the anchor pad and the retainer of FIG. 19.

[0043]FIG. 25 is an exploded, perspective view of the connector fittingand the catheter hub of FIG. 20, a portion of the elongated body of theconnector fitting being aligned with the anchor pad and the retainer ofFIG. 19.

[0044]FIG. 26 is an exploded, perspective view of the connector fittingand the catheter hub of FIG. 20, the connector fitting being alignedwith an anchor pad and a retainer of the securement device of FIG. 1.

[0045]FIG. 27A is a rear perspective view of a retainer configured inaccordance with another preferred embodiment of the present invention.

[0046]FIG. 27B is a front perspective view of the retainer of FIG. 27A.

[0047]FIG. 27C is a top plan view of the retainer of FIG. 27A.

[0048]FIG. 27D is a rear elevational view of the retainer of FIG. 27C.

[0049]FIG. 27E is a bottom plan view of the retainer of FIG. 27D.

[0050]FIG. 27F is a side elevational view of the retainer of FIG. 27A.

[0051]FIG. 27G is a cross-sectional view of the retainer of FIG. 27Ftaken along line 27G-27G.

[0052]FIG. 27H is a front view of the retainer of FIG. 27C.

[0053]FIG. 27I is a cross-sectional view of the retainer of FIG. 27Dtaken along line 27I-27I.

[0054]FIG. 27J is a side elevational view of the retainer of FIG. 27Fengage with a connector fitting that is secured to a catheter hub.

[0055]FIG. 28 is an exploded, perspective view of the connector fittingand the catheter hub of FIG. 20, the connector fitting being alignedwith an anchor pad and a retainer of the securement device of FIG. 27A.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0056] The following description and the accompanying figures, whichdescribe and show the preferred embodiments, are made to demonstrateseveral possible configurations that a securement system can take toinclude various aspects and features the invention. The illustratedembodiments are shown in use with either one or both of an illustrativeexample of a catheter hub and an illustrative example of a connectorfitting with a spin nut for connection to the catheter hub. Theillustration of the securement device in this context is not intended tolimit the disclosed aspects and features of the invention to thespecified embodiments or to usage only with the illustrated connector orhub. Those of skill in the art will recognize that the disclosed aspectsand features of the invention are not limited to any particularembodiment of a securement system, and securement systems, which includeone or more of the inventive aspects and features herein described, canbe designed for use with a variety of medical articles.

[0057] To assist in the description of these components of thesecurement system, the following coordinate terms are used (see FIG. 1).A “longitudinal axis” is generally parallel to a portion of the catheterhub, the connector fitting or other medical article retained by thesecurement system, as well as parallel to the axis of a channel of theretainer, through which the medical article extends. A “lateral axis” isnormal to the longitudinal axis. A “transverse axis” extends normal toboth the longitudinal and lateral axes. In addition, as used herein,“the longitudinal direction” refers to a direction substantiallyparallel to the longitudinal axis; “the lateral direction” refers to adirection substantially parallel to the lateral axis; and “thetransverse direction” refers to a direction substantially parallel tothe transverse axis. The term “axial” as used herein refers to the axisof the channel or connector fitting, and therefore is substantiallysynonymous with the term “longitudinal” as used herein. Also, the terms“proximal” and “distal”, which are used to describe the presentsecurement system, are used consistently with the description of theexemplary applications (i.e., the illustrative examples of the useapplications). Thus, proximal and distal are used in reference to thecenter of the patient's body. The terms “upper,” “lower,” “top,”“bottom,” “underside,” “upperside” and the like, which also are used todescribe the present securement system, are used in reference to theillustrated orientation of the embodiment. For example, the term“upperside” is used to describe the portion of the retainer that islocated above a lateral axis that passes through the axis of thechannel. The term “underside” is used to describe the portion of theretainer that is located below a lateral axis that passes through theaxis of the channel. Brief introductions to some of the features, whichare common to the described embodiments of the securement systems, arenow described. In the illustrated embodiment, the arrows on thesecurement device point in the direction toward the insertion site(i.e., in the proximal direction).

[0058] The preferred embodiments of the present invention advantageouslyprovide a medical line securement system for securing a medical articleto a patient. The medical article preferably has an elongated body. Theelongated body cooperates with a retainer to arrest movement of themedical article in longitudinal, lateral, and transverse directions whenplaced within the retainer.

[0059] In each of the embodiments described below, the retainer has abody member which includes an inverted channel formed therethrough. Theinverted channel has a longitudinal access opening located on anunderside of the retainer to allow ingress or egress of the medicalarticle. The medical article is installed or removed from the undersideof the retainer via this access opening. Such an arrangement allows themedical provider to align at least a portion of the medical article withthe retainer prior to fixing the retainer to the patient's skin. In thisway, the inverted channel retains a portion of the medical article.

[0060] The retainer includes at least one abutment (preferably anabutment surface) that cooperates with at least one contact point orsurface on the medical article. The one or more abutments of theretainer extend generally normal to the axis of the channel and can be,for example, but without limitation a surface, a wall of a slot, aridge, a protuberance, or like structures. The abutment cooperates withthe one or more contact points or surfaces of the medical article toinhibit longitudinal movement of the medical article through thechannel. For example, the abutment could be a surface on the distal endof the retainer that acts against at least a portion of a radiallyextending member or spin nut of the medical article. In this way, themedical article will be limited in it proximal movement (i.e., movementtoward the patient) once the radially extending member contacts or abutsagainst the distal end of the retainer.

[0061] The retainer of each embodiment described below further includesat least one support that is preferably disposed on the underside of theretainer at a position lower than the access opening. With thisconstruction, the retainer holds the retained portion of medical articleaway from the patient's skin, when the retained portion is positionedwithin the retainer channel, to avoid chaffing or excoriating the skin.The support in each of the illustrated embodiments includes left andright mounting wings that are integral with the body member and areattached to left and right anchor pads. The lower surfaces of the leftand right anchor pads attach to the patient's skin.

[0062] The retainer and anchor pad(s) also can have other constructionsin order to inhibit contact between the skin and the retainer, as wellas between the skin and the retained portion of the medical article. Forexample, the anchor pads can be thicker, in which case the mountingwings can be located higher on the retainer body.

[0063] To facilitate a complete understanding of the embodiment, theremainder of the detailed description describes the securement systemwith reference to the figures, wherein like elements among theembodiments are referenced with like numerals throughout the followingdescription.

[0064]FIG. 1 is a perspective view of a securement device 100 configuredin accordance with an embodiment of the present invention and FIG. 2 isa top plan view of the securement device 100 of FIG. 1. As shown inFIGS. 1 and 2, the illustrated securement device 100 comprises threemain components: two anchor pads 110(a), 110(b) and a retainer 120. Theillustrated retainer 120 includes a left footing/mounting wing 210(a)and right footing/mounting wing 210(b). Each mounting wing is disposedupon the respective one of the anchor pads 110(a), 110(b). The mountingwings 210(a), 210(b) extend in a lateral direction away from a center ofthe retainer 120.

[0065] As noted above, the securement device 100 can form a component ofa catheterization or securement system that also includes one or moremedical articles, such as connector fittings, catheters, hubs, catheteradaptors, fluid supply lines, or other articles suitable for securementvia the anchor pads and retainer. An opening in the retainer 120 isaligned with the medical article. The medical article is insertedbetween the anchor pads 110(a), 110(b), through the opening, and intothe retainer 120. The anchor pads 110(a), 110(b) are then secured to theskin of the patient, generally by an adhesive disposed upon the bottomsurface of the pads. In this way, the retainer 120 secures the medicalarticle to the patient. Thus, the retainer at least restricts, if notprevents, lateral and transverse movement of the retained section of themedical article. Additional features of the securement device 100 canrestrict, if not prevent, longitudinal and rotational movement of theretained section of the medical article. The embodiment illustrated ispreferably for use with a catheter adapter or hub, as described withreference to FIGS. 15A and 15B. The embodiments of the anchor pad andthe retainer are described in more detail below.

[0066] Anchor Pad

[0067]FIGS. 3 and 4 illustrate the anchor pads 110(b), 110(a),respectively, apart from the rest of the securement device 110 shown inFIG. 2. The general structure of each anchor pads 110(a), 110(b)comprises a generally rectangular shape with a scalloped region 112located at a comer of each anchor pad. The scalloped configuration easesthe process of aligning the securement device 100 with a catheterinsertion site in the patient's skin. Although only a single shape ofthe anchor pad is illustrated in FIGS. 3 and 4, those of skill in theart will recognize that a variety of shapes can be used.

[0068] Each anchor pad 110 desirably comprises a laminate structure withan upper plastic, paper or foam layer (e.g., closed-cell polyethylenefoam) and a lower adhesive layer. The lower adhesive layer constitutes alower surface 160 of the anchor pad. The lower surface 160 desirably isa medical-grade adhesive and can be either diaphoretic ornondiaphoretic, depending upon the particular application. Such foamwith an adhesive layer is available commercially from Avery Dennison ofPainsville, Ohio. While not illustrated, the anchor pads 110(a), 110(b)can include suture holes in addition to the adhesive layer to furthersecure the anchor pad to the patient's skin.

[0069] In other variations, a hydrocolloid adhesive or zinc oxide-basedadhesive can advantageously be used upon the anchor pads 110(a), 110(b)for attaching the anchor pads to the skin of the patient. Thehydrocolloid or zinc oxide-based adhesive can be used either alone or incombination with another medical grade adhesive (e.g., in combinationwith the adhesive available from Avery Dennison). Hydrocolloid and zincoxide-based adhesives have less of a tendency to excoriate the skin of apatient when removed. This can be particularly important for patientswhose skin is more sensitive or fragile, such as neonates and those witha collagen deficiency or other skin related condition.

[0070] In another variation, each anchor pad 110(a), 110(b) comprises alaminate structure with an upper woven layer and a lower adhesive layer.The upper layer can be polyester or other suitable polymer or textilematerials. One particular suitable material is a woven polyesteravailable commercially under the name “Tricot” from Tyco. The loweradhesive layer constitutes the lower surface 160 of the anchor pad. Thelower surface desirably is a medical-grade adhesive and can be eitherdiaphoretic or nondiaphoretic, depending upon the particularapplication.

[0071] A surface of the upper foam layer constitutes an upper surface170 of the anchor pads 110(a), 110(b). The upper surface 170 can beroughened by corona-treating the foam with a low electric charge. Theroughened or porous upper surface can improve the quality of theadhesive joint (which is described below) between the mounting wings 210and the anchor pads 110. In a further variation, the flexible anchor padcan comprise an upper paper or other woven or nonwoven cloth or plasticlayer in lieu of a roughened upper foam surface.

[0072] The anchor pads 110(a), 110(b) preferably are arranged withrespect to the retainer 120 such that the tip of the medical articledoes not extend beyond the front edge of the mounting wings 210 when themedical article is properly inserted within the retainer 120. Thehealthcare provider can be instructed to generally align the medicalarticle tip with the front edges of the anchor pads 110(a), 110(b)before inserting the medical article into the retainer 120.

[0073] As illustrated in FIG. 3, a removable paper or plastic releaseliner 180 desirably covers the adhesive lower surface 160 before use.The liner 180 preferably resists tearing and desirably is divided into aplurality of pieces to ease attachment of the pad to a patient's skin.

[0074] The liner 180 comprises a folded over portion to define a pulltab 190 (see FIG. 1). The pull tab can be utilized to remove the paperor plastic release liner 180 from their adhesive lower surface 160before use. A healthcare provider uses the pull tab 190 by grasping andpulling on it so that the liner 180 is separated from the lower surface160. The pull tab 190 overcomes any requirement that the healthcareprovider pick at a comer edge or other segment of the liner in order toseparate the liner from the adhesive layer.

[0075] The pull tab 190 of course can be designed in a variety ofconfigurations. For example, the pull tab 190 can be located along acenter line of the anchor pad 110; or alternatively, the pull tab can belocated along any line of the anchor pad 110 in order to ease theapplication of the anchor pad onto the patient's skin at a specificsite. For example, an area of a patient's skin with an abrupt bend, suchas at a joint, can require that the pull tab 190 be aligned toward oneof the lateral ends of the anchor pad 110 rather than along the centerline. In the embodiment illustrated in FIGS. 3 and 4, the pull tab 190extends from a bottom surface of the anchor pads 110(a), 110(b) andalong an outer line 195.

[0076] The fold that forms the pull tab 190 preferably occurs laterallybeyond the inner (medial) edge on each anchor pad 110(a), 110(b), asbest seen in FIG. 2, rather than at the inner edge of the anchor pad110(a), 110(b). Thus, the spacing between the folds of the releaseliners 180 is less than the spacing between the inner edges of theanchor pads 110(a), 110(b). The projection of the release linear beyondthe anchor pad inner edge provides an area onto which any adhesive,which is used to attach the retainer to the anchor pad, can run whilelessening the occurrence of such adhesive contacting the fold. Cracksoften occur at the fold and presence of adhesive in such cracks cancreate delimitation of the release liner and incomplete removal of therelease linear when peeled away from the corresponding anchor pad110(a), 110(b).

[0077] Additionally, the distal side of each release linear is cut toincrease a “view window” through which a healthcare provider can seewhen aligning the retainer over the medical article (e.g., the catheterhub and/or the connector fitting). Preferably, the resulting relieforiginates from the inner edge of the release linear generally at aright angle thereto and then transitions into a shape that generallymatches the shape of the adjacent region of corresponding anchor pad110(a), 10(b). The initial right-angle cut of this relief reducesinstances of the release linear ripping when properly pulled in thelateral direction away from the retainer 120.

[0078] Retainer

[0079] An embodiment of the retainer 120 is described with reference toFIGS. 5-13. FIG. 5 is a top plan view of the retainer 120 which limitsrotation of an installed catheter hub as well as arrests movement of thecatheter hub in the longitudinal, lateral and transverse directions.FIG. 6 is a front side view of the retainer 120 from FIG. 5 andillustrates a body member 130 and footings/side mounting wings 210(a),210(b) that extend in a lateral direction from either side of the bodymember. As shown in FIGS. 7 and 8, the body member 130 is elongated inthe longitudinal direction and comprises a generally parallelepipedshape. It is advantageous for the longitudinal dimension of the bodymember 130 to be sufficiently long to provide stability to the retainedportion of the medical article along its length. In this way, thelongitudinal length of the retained portion is sufficient to inhibit therocking of the medical article within the retainer 120. Also, thelateral dimension of the body member 130 of the retainer desirablyallows the healthcare provider to easily and naturally grip the bodymember.

[0080] With reference to FIG. 6, the inner side of the body member 130faces towards the patient's skin when in use and preferably defines aninverted central channel 140. The inverted channel 140 extends on theunderside of the body member 130 in a longitudinal direction forreceiving a section of the catheter hub in the illustrated embodiment.

[0081] The channel 140 is capable of receiving a portion or length ofthe medical article and is generally configured to house, to preferablygrip, and to secure this portion of the medical article. In theillustrated embodiment (see FIGS. 5 through 8), the central channel 140has a generally semi-circular cross-sectional shape. An inner surfacecontour of the central channel 140 preferably is selected depending onthe geometry of the portion of the medical article to be retained. Forexample, in a retainer 120 that is configured to retain a portion of amedical article that has a constant outer diameter, the central channel140 preferably has a constant radius along its length. In contrast, in aretainer 120 configured to retain a portion of a medical article thathas a tapering outer surface, the central channel 140 preferably has atapering inner surface and a radius that varies along the channellength. Additional embodiments of the central channel 140 of theretainer can comprise a plurality of different radii and/or taperingregions. For example, as illustrated in FIGS. 14A and 14B, the channel140 can have two sections: a first proximal section 140(a) have agenerally uniform cross-sectional size along its length while a seconddistal section 140(b)has a tapering shape along its length. An abutmentwall forms a transition between these two sections of the channel. Thesesections 140(a), 140(b) of the channel 140 can also both be tapered orstraight (i.e., have a generally uniform radius along the length of thesection) or the distal section can be straight and the proximal sectioncan be tapered. In this way, the size and shape of the central channel140 can be chosen to match or to approximate the size and shape of themedical article or portion thereof, e.g., the catheter hub, to beretained. By matching the inner surface contour of the central channel140 to the outer surface of the secured portion of a medical article, amore effective securement may be achieved. In addition or in thealternative, effective securement can also be achieved by the engagementof one or more abutment surface of the retainer with one or more contactsurfaces on the medical article. Each abutment surface can cooperatewith a contact surface on the medical article to inhibit movement of themedical article relative to the retainer. Exemplary abutment surfacesand contact surfaces are described below with reference to FIGS. 16-18.

[0082] Although the central channel 140 can be formed in various shapesdepending upon the desired application (e.g., depending upon a shape ofthe retained portion of the medical article for which the retainer isdesigned to be used), the central channel 140 desirably has a sufficientlength in the longitudinal direction to stabilize the connector fitting,catheter hub, or other medical article, rather than act as a fulcrum forthe fitting, as mentioned above. That is, the retainer 120 receives asufficient length of the catheter hub to inhibit movement of the hub inthe lateral, longitudinal and transverse direction (i.e., to inhibityaw, pitch and axial movement of the article).

[0083] As shown most clearly in FIGS. 6 and 12, the lower side of theretainer 120 includes an access or lower opening 150. In someembodiments, the lower opening 150 has generally tapering sides alongthe longitudinal axis to match generally the shape of the medicalarticle. In other embodiments, the lower opening 150 has generallyparallel sides while the channel 140 is tapered to match generally theshape of the medical article. The lower opening 150 may includecontouring (e.g., chamfers) along its periphery in order to guide themedical article into the central channel 140 when inserting the medicalarticle into the retainer 120.

[0084] The illustrated retainer 120 further comprises at least oneretention surface 165( ), 165(b) disposed on a lower side of theinverted channel 140. The retention surface holds at least a portion ofthe retained medical article within the channel 140 and hence away fromthe patient's skin. This support can be provided by, for example, anadhesive, a region of the inverted channel which provides a degree ofsnap-fit with the retained medical article, two or more regions of theinverted channel which provide a degree of snap-fit with the retainedmedical article, or a combination of the adhesive and a region ofsnap-fit. The adhesive can be located on one or more surfaces of theretainer 120 that contact the medical article. For example, the adhesivecould be located on the surface of the inverted channel or on anabutment.

[0085] As shown most clearly in FIGS. 9 through 11, the presentembodiment of the retainer 120 includes multiple pairs of retentionsurfaces 165(a), 165(b). The corresponding retention surfaces 165(a),165(b) of each pair lie on opposite sides of the access opening 150 fromeach other. In this embodiment, the retention surface 165(a) is aportion of the surface that defines the central channel 140 and islocated on the lower side of the central channel 140. The retentionsurface 165(a) is located to one side of the central axis. The otherretention surface 165(b) is a portion of the surface that defines thecentral channel 140 and is located on the lower side of the centralchannel 140. The retention surface 165(b) is further located to the sideof the central axis that is opposite to the retention surface 165(a).Once the medical article is placed in the central channel 140, theretention surfaces 165(a), 165 (b) each hold a portion of the retainedsection of the article within the channel 140. While multiple retentionsurfaces are illustrated in FIGS. 9 through 11, either retention surface165(a), (b) can be individually employed in variations of the presentretainer and still support the medical article within the channel 140.

[0086] As shown most clearly in FIG. 11, the retention surfaces 165(a),165(b) are both located generally at a distance X measured in atransverse direction from the axis of the central channel 140. DistanceX preferably is less than radius R when measured at the same locationalong the central channel 140.

[0087] Pressure can be provided by the retention surfaces 165 whichholds the medical article within the retainer 120 in the illustratedembodiment. The retention surfaces 165 provide a degree of snap fitbetween the retainer 120 and the medical article. The degree of snap-fitcan be increased by extending the overall surface of the central channel140 through an arc of greater than 180°. As shown most clearly in FIG.6, in one embodiment the arc extends for more than 180 degrees in orderto more firmly support the retained portion of the medical article. Inthe illustrated embodiment, the walls of the central channel 140 extendthrough an arc of approximately 270°. The length of such an arc providesa snap-fit securement between the central channel 140 on the body member130 and the secured portion of the medical article. In this way, themedical article can be placed in position prior to attaching thesecurement device 100 to the patient without concern that the medicalarticle will shift while the healthcare provider is attaching the device100 to the patient. Additionally, the releasable engagement provided bysnap-fit connection also permits the retained portion of the medicalarticle to be readily released from retainer 120.

[0088] In the illustrated embodiment, as best seen in FIG. 11, chamferedsurfaces 240(a) are formed on the underside of the retainer body 130along one of the lower edges of the access opening 150. A second set ofchamfered surfaces 240(b) are formed on the underside of the retainerbody 130 along the other lower edge of the access opening 150. Theportions of the retainer body 130 between these chamfered surfaces 240and the retention surfaces 165 form hips 270. In other words, the hips270 are the portion of the body 130 that is defined by a lower side ofthe central channel 140 (either the retention surfaces 165(a) on oneside of the central axis or the retention surfaces 165(b) on the otherside of the central axis), the chamfered surfaces 240, and the sides ofthe narrow lower opening 150. In one embodiment, the chamfered surfaces240(a) on one side of the central axis are oblique to the chambersurfaces 240(b) on the other side of the central axis and help guide themedical article into the lower opening 150 and the central channel 140.

[0089] The retainer 120 can include a generally rigid structure (atleast in comparison to foam or tape) and is principally defined by thebody member 130 and the mounting wings 210(a), 210(b). The body member130, however, preferably is somewhat flexible in nature, due both inpart to its structure and to the material used to form the body member130. Suitably rigid but flexible materials include, for example, butwithout limitation: plastics, polymers or composites such aspolypropylene, polyethylene, polycarbonate, polyvinylchloride,acrylonitrile butadiene styrene, nylon, olefin, acrylic, polyester, aswell as moldable silicon, thermoplastic urethane, thermoplasticelastomers, thermoset plastics and the like. However, other materialscan be utilized.

[0090] The body member 130 and mounting wings 210(a), 210(b) areintegrally formed to comprise a unitary retainer. This can beaccomplished in any of a variety of ways well known to those skilled inthe art. For instance, the entire retainer can be injection molded inorder to reduce fabrication costs. The illustrated retainer 120preferably is formed by injection molding using polyethylene orpolypropylene material. The retainer, however, can comprise anon-unitary body member 130 and mounting wings 210(a), 210(b). In thismanner, the body member and one or both of the mounting wings is formedseparately and then coupled together. Additionally, the body member andmounting wings can have other forms and can have other orientationsrelative to one another. The body member 130 also can be clear ortransparent to facilitate alignment of the retainer 120 with thecatheter hub or other medical article during installation.

[0091] Each mounting wing 210(a), 210(b) preferably comprises a glue damaround a portion of its periphery on its underside. The glue damrestricts adhesive flow beyond an inner edge of the respective mountingwing. The outer edge of each mounting wing 210(a), 210(b) does notinclude the glue dam (as best seen in FIG. 11) to allow any excess glueor adhesive to seep out from under the mounting wing during themanufacturing process in the lateral direction away from the retainer120.

[0092] The body member 130 of the retainer is attached to the uppersurface 170 of the anchor pad 110 via the mounting wings 210(a), 210(b),as is shown in FIG. 2. The body member is desirably secured to the uppersurface of the pad by a solvent bond adhesive, such as cyanoacrylate orother bonding material. One such adhesive is available commercially asPart No. 4693 from the Minnesota Mining and Manufacturing Company (now3M).

[0093] When the anchor pads 110 are secured to the skin of the patient,the medical article is inhibited from moving substantially in either thelateral or transverse directions relative to the patient. Longitudinalmovement of the medical article is inhibited by engagement between atleast one abutment surface on the retainer 120 and a contact surface ormating surface on the medical article. The abutment surface on theretainer 120 preferably extends generally normal to the axis of thecentral channel 140. The abutment surface can be located at or betweenthe distal and proximal ends of the retainer 120. For example, theabutment surface can be either the proximal or distal ends of theretainer (as will be apparent from the embodiments described later).Moreover, multiple abutment surfaces on the retainer 120 can be employedwith each abutment surface being the same or a different type ofabutment surface. Additionally, the abutment surface can be used toarrest movement in one longitudinal direction and the shape of thechannel can be used to arrest movement in the opposite longitudinaldirection. For example, at least a portion of the channel 140 can have atapering inner surface and the retainer can include an abutment surfacein the form of the proximal end of the retainer. The tapering shape andabutment surface cooperate to inhibit longitudinal motion in bothlongitudinal directions. In such an embodiment, the tapering surfacecontacts an outer tapering surface of the medical article to limitmotion in one direction. Likewise, the proximal end of the retainerabuts with a radially extending member on the medical article to limitmotion in the opposite direction.

[0094] The retainer 120 thus preferably includes one or more abutmentsurfaces. In the illustrated embodiment, the retainer includes multipleabutment surfaces that are formed by one or more slots 220 in the bodymember 130. In the form of a slot 220, one abutment surface forms oneside of the slot and another abutment surface forms the other side ofthe slot 220.

[0095] To arrest longitudinal motion in the illustrated embodiment, twocontact surfaces in the form of a single radially extending member areemployed on the medical article. The radially extending member extendsthrough the slot 220 in the retainer 120 to inhibit longitudinal motionof the medical article in both directions. The contact between the twoabutment surfaces on the retainer and their corresponding contactsurfaces on the medical article arrests motion in the longitudinaldirection. Further embodiments of the retainer 120 inhibit rotationalmovement of the installed medical article. This will be discussed ingreater detail below.

[0096] As shown in FIG. 5, the retainer 120 includes pairs of abutmentsurfaces with each pair forming one lateral slot 220 (preferably fourabutment surfaces form at least two slots) that are sized to receive aradially extending portion of the catheter (e.g., a push tab thatextends from a catheter hub). These slots 220 can extendcircumferentially about at least a portion of the axis of the centralchannel 140. Each slot has a longitudinal length sufficient to acceptthe radially extending member of the retained medical article.

[0097] The radially extending portion of the medical article ispreferably in the form of a push tab. An embodiment of a push tab isdescribed with reference to FIGS. 15A and 15B. In particular, it can bedesirable for the longitudinal length of each slot to be sufficient toreceive the push tab 310 of the medical article; however, each slot 220can be slightly larger than the push tab's thickness (as measured in thelongitudinal direction) and a gap can exist between one or both sides ofthe push tab and the corresponding abutment surfaces that define theslot 220 into which the push tab has been inserted. In a preferred form,at least two or three annular slots 220 are disposed within the retainer120. The longitudinal length of each slot 220 preferably is about fivethousandths of an inch (0.005 inch, 0.127 mm) larger than the radiallyextending member (e.g., the push tab). Such an arrangement can bedesirable to minimize longitudinal movement of the retained portion(e.g., the tab 310 in FIG. 15B) of the medical article. Accordingly, asmall gap can exist between any abutment surface and a correspondingcontact surface before the medical article is shifted relative to theretainer 120. Once shifted, however, further longitudinal movement isprevented by the interference between the contact surface and theabutment surface.

[0098] Those of skill in the art will recognize that each slot 220 neednot have identical radial extent. The radial extent of each slot 220need not be uniform about the axis of the central channel 140.

[0099] The inner edges of each slot 220 can be chamfered so as to easethe insertion of a radially extending member into any slot 220. Byhaving the edges of each slot chamfered, it becomes possible to move aradially extending member 310 into a slot 220 even if the initialalignment between the center of the slot and the center of the radiallyextending member is not exact. The use of chamfered edges on the slots220, as well as the presence of slots located at multiple longitudinalpositions along the length of the central channel 140, allows for amedical article to be placed into the central channel of the retainer120 with only coarse alignment with the axis of the central channel. Themedical article generally moves into the nearest slot 220 as the medicalarticle is pressed up into the retainer 120 from below (that is, as theretainer 120 is pressed over the retained portion of the medicalarticle). The chamfered surfaces 240(a), 240(b) adjacent to the mountingwings 210(a), 210(b) help guide the medical article into the centralchannel 140. The alignment process is further facilitated when a portionof the retainer 120 is transparent.

[0100] As shown most clearly in FIGS. 6, 11, and 13, an upper section ofthe retainer 120 further comprises a depression 135 which forms a fingerpad that a healthcare provider can press down upon. The depression 135encourages the finger to push down on the retainer 120 and discouragesthe healthcare provided from gripping the retainer 120 on its sidesduring application. Such a side grip could squeeze or constrict theretainer 120 and make it harder to slip the retainer 120 over themedical article. By pushing down on the retainer 120, this constrictiveeffect is avoided.

[0101] As illustrated in FIGS. 6 and 13, a base surface 230 of theretainer 120 can have a concave curved shape when viewed from the frontand rear sides. The degree of curvature can be varied depending on theexpected location of usage or application of the securement device 100.It will be appreciated that many common sites for insertion of medicallines which require securement will be located on anatomical regionsexhibiting convex curvature, such as a dorsal side of a hand, a arm, aleg, a contact surface, etc. By providing a concave bottom profile tothe retainer 120, the retainer will rock less once placed upon thepatient via the anchor pads 110(a), 110(b).

[0102]FIGS. 7 and 8 are side views of the retainer 120 of FIG. 5. Asillustrated in FIGS. 7 and 8, an axis 260 of the central channel 140lies at an angle with respect to the base surfaces 230 of the retainer120. The desired angle between the medical article and the patient iscreated by angling the axis 260 of the central channel 140. This angleis selected in order to align the axis 260 of the channel 140 of theretainer with the desired incident angle with which the medical articleis to contact the skin of the patient. A variety of different angles canbe used, ranging from 0° to 45°, and more preferably from 5° to 25°. Forinstance, for the securement of intravenous catheters, it is desirablefor the angle of incidence of the catheter to the skin of the patient tobe between about 7° to about 15°. For the securement of arterialcatheters, it is desirable for the angle of incident of the catheter tothe skin of the patient to be about 12.5°. By angling the axis 260 ofthe channel 140 at the desired angle, which will depend upon theparticular securement application (e.g., securing an arterial catheter,an intravenous catheter, etc.), the proper angle of incidence for acatheter can be maintained.

[0103] As illustrated in FIG. 5, the retainer 120 further comprises ribs280. The ribs 280 project away from the outside surface of the channel140. Such ribs may be formed by extending portions of the slots 220 ofthe retainer 120 away from the channel 140. The ribs 280 provideadditional surfaces for the healthcare provider to grip the retainer120.

[0104] As shown most clearly in FIGS. 5 and 7 through 10, locatedadjacent to the slots 220 are upper sections 250. The thickness of theupper sections 250 in the longitudinal direction can vary in order tomaintain a generally constant spring force along the entire length ofthe retainer 120. In this way, the same amount of force is required tospread the walls of the retainer 120 apart even though in theillustrated embodiment the back end of the retainer 120 spreads more toreceive the larger diameter section of a tapered catheter hub. Asillustrated in the cross-section views of FIGS. 9 and 10, thelongitudinal and transverse lengths of the upper sections 250 varybetween one or more of the upper sections.

[0105] Although certain features of the retainer 120 can be specificallyconfigured for use with a catheter hub, it will be understood by thoseof skill in the art that such a retainer 120 can be used with otheradaptors or medical lines as well. Furthermore, the retainers describedherein can be modified to more effectively cooperate with various typesof connector fittings and adaptors.

[0106] As shown in FIGS. 5 through 13, each slot 220 is substantiallyannular in form. However, as illustrated most clearly in FIG. 11, a stopmember or wall 290 preferably extends into the path of the one or moreslots 220 at a circumferential location about the axis of the centralchannel 140. A comparison of FIGS. 9 and 10 illustrates that the wall290 in the illustrated embodiment is located on the mounting wing 210(b)side of the retainer 120. As shown in FIG. 11, the wall 290 in theillustrated embodiment extends in a lateral direction away from themounting wing 210(b) and into one or more slots 220. In this way, thewall 290 limits the rotation of the radially extending member andmedical article when the medical article is installed in the retainer120. Thus, in the illustrated embodiment, one or more slots 220 extendcircumferentially about the axis of the central channel 140 for lessthan 360 degrees.

[0107] The wall 290 can be located at other locations around thecircumference of the central channel 140. For example, the wall 290could extend in a lateral direction away from the mounting wing 210(a)and into one or more slots 220. In embodiments of the retainer 120 wherethe wall 290 extends into less than all of the slots 220, the healthcareprovider can select whether to restrict the rotation of the medicalarticle. For example, the healthcare provider can restrict the rotationof the medical article by inserting a radially extending member of themedical article into a slot 220 that includes the wall 290.Alternatively, the healthcare provider can install the radiallyextending member into a slot 220 that does not include the wall 290 toallow unbridled rotation of the medical article. Moreover, more than onewall 290 can be located around the circumference of the one or moreslots 220 to further limit the rotation of the medical article. In stillfurther variations of the retainer, the retainer can omit the wall(s)290.

[0108] Each slot 220 preferably has a lateral width sufficient toreceive the radially extending member of the medical article. In thisway, the retainer 120 is designed to grip non-winged cathetersregardless of the position of the radially extending member. Forexample, in the illustrated embodiment, a catheter hub can be installedinto the retainer 120 regardless of rotation of the catheter hub aboutits axis except when the catheter hub is rotated such that the radiallyextending member coincides with the wall 290. The slot 220 can initiallyreceive the radially extending member whether the radially extendingmember is pointing away from the patient, toward the patient, to eitherside, or generally at any other angle about the axis of the catheterhub. However, when the radially extending member is pointing directly tothe left side and the catheter hub enters the opening 150, the radiallyextending member contacts the wall 290. As the catheter hub is furtherinstalled into the retainer 120, the catheter hub is forced to rotatesuch that the radially extending member is pointing downward. When theradially extending member is pointing downward, the radially extendingmember will follow the catheter hub into the retainer 120 as thecatheter hub is inserted through the opening 150. Once the catheter hubhas rotated and is subsequently fully installed in the retainer 120, thewall 290 will not allow the catheter hub and radially extending memberto rotate completely about the axis of the central channel 140. Forexample, as the catheter adapter is rotated, the radially extendingmember of the catheter hub slides within the slot 220. However, at somepoint during the rotation of the catheter hub, the radially extendingmember contacts the wall 290.

[0109] In the embodiment illustrated in FIGS. 5 through 13, the wall 290limits the rotation of the radially extending member when the push tapis sufficiently rotated in either direction towards the mounting wing210(b) side of the retainer 120. In this way, the wall 290 prohibits thecatheter hub from 360-degree rotation while the catheter hub isinstalled in the retainer 120.

[0110] When the radially extending member points downward (e.g., towardthe patient) and generally normal to the bottom surfaces of the retainer120, the radially extending member extends through the lower opening150. The hips 270 in the lower opening 150 are spaced sufficiently closeto capture the radially extending member in this position and therebyinhibit longitudinal movement of the catheter hub.

[0111]FIG. 12 is a bottom plan view of the retainer 120 and illustratesthat the distance between the side mounting wings 210(a), 210(b) variesin the region of the retainer 120. Width W1 is measured between the sidemounting wings 210(a), 210(b) in a lateral direction as shown. Width W2is measured between the side mounting wings 210(a), 210(b) in a lateraldirection as shown. FIG. 13 is a rear side view of the retainer 120 andfurther illustrates the widths W1 and W2 from FIG. 12. The side mountingwings 210(a), 210(b) are designed so that width W1 is less than thewidth W2. Width W1 is selected to deter backward insertion of themedical article into the retainer 120. For example, the width W1 couldbe selected to be smaller than a spin nut or the connector end of thecatheter hub. With W1 less than W2, the potential for the medicalarticle being incorrectly inserted into the retainer 120 is reduced.

[0112] Medical Articles

[0113] An exemplary medical article for use with the embodiment of thesecurement device described above will now be described with referenceto FIGS. 15A and 15B. The medical article can be a single medicalarticle or a combination of one or more medical articles. Such medicalarticles can be or include, for example, but without limitation,connector fittings, catheters, catheter hubs, catheter adaptors, fluidsupply lines, or other similar articles. FIG. 15A is a perspective viewof a catheter hub 430 and a connector fitting 300 with a spin nut 330.The connector fitting 300 is preferably disposed upon the end of amedical line 360 which can be connected to a drip bag, blood monitor, orother fluid related medical apparatus. While the retainer 120 of FIG. 2is configured to receive a portion of the catheter hub 430, the retainercan be configured for use with the connector fitting 300, as will bedescribed8.

[0114] The connector fitting 300 comprises an elongated body 320 whichis attached to the end of the medical line 360. The connector fitting300 also comprises a portion that is tapered along at least part of itslongitudinal length so as to allow the end of this region to fit withinthe tapered conical portion of an catheter hub 430. The tapered portion350 of the connector fitting 300 also preferably includes a centrallydisposed lumen that communicates with the lumen of the medical line.

[0115]FIG. 15B is a perspective view of the connector fitting 300 ofFIG. 15A with the spin nut 330 secured in the proximal position andsecured to the catheter hub 430. When the connector fitting 300 isinserted into the catheter hub 430, the lumen of the connector fittingis disposed in fluid communication with the lumen of the catheter hub430. This provides fluid communication between the medical line 360 andthe patient.

[0116] As seen in FIGS. 15A and 15B, the connector fitting 300 has atleast two contact surfaces in the form of one radially extending element370(a) disposed upon an end of the elongated body 320 of the connectorfitting 300 opposite the tapered end 350. It may be advantageous for theradially extending element 370(a) to extend completely around thecircumference of the connector fitting 300. Additional contact surfacesin the form of a second radially extending element 370(b) can also bedisposed upon the elongated body 320, as can additional radial elements(not shown). Those of skill in the art will recognize that the radiallyextending element or elements 370(a) need not have any particular shapeor longitudinal thickness. Additionally, the radially extending elementsneed not have the same shape. For instance, the first radially extendingelement 370(a) can have the hexagonal shape illustrated and the secondradially extending element 370(b) can have a circular shape.

[0117] A spin nut 330 is disposed upon the connector fitting 300 aroundthe elongated body 320 of the fitting. The spin nut 330 is substantiallycylindrical in form and is able to move upon the connector fitting 300.The spin nut 330 is capable of both rotational motion around the axis ofthe connector fitting and axial motion in both the proximal and distaldirections along the length of the elongated body 320 of the fitting.The spin nut 330 also includes internal screw threads which areillustrated with phantom lines in FIGS. 15A and 15B.

[0118] Still referring to FIGS. 15A and 15B, an catheter hub 430includes a body that, in the illustrated embodiment, is configured as acatheter hub and has a generally conical shape and tapers from a largeradius to a smaller radius along its length. In the illustratedembodiment, the catheter hub 430 comprises two contact surfaces thattogether form a radially extending member. The radially extending membercan be, for example, a lateral tab 310 which is disposed at a positionalong the length of the body of the hub. The tab 310 can be gripped bythe healthcare provider from the upper side of the retainer 120 in orderto immobilize the catheter hub 430 when unscrewing the spin nut 330 orotherwise disengaging the connector fitting 300 from the catheter hub.

[0119] The catheter hub 430 also can include an external screw thread onthe outside of the conical body near the end with the larger radius. Thescrew thread can be used in association with the spin nut 330 of theconnector fitting 300 in order to securely interconnect the connectorfitting 300 and the catheter hub 430.

[0120] The at least one retention surface 165 supports the medicalarticle so that the medical article is elevated in the retainer 120 suchthat the retained portion of the medical article (e.g., the retainedportion of the catheter hub) is raised from the patient's skin to lessenor eliminate compression, excoriation, and/or chaffing of the skin.Thus, the retainer 120 lifts and holds the retained portion of thecatheter hub up from the patient's skin.

[0121] With reference to FIG. 11, dimensions L1 and L2 illustrate howthe wall 290 described above prohibits 360-degree rotational movement ofthe catheter hub 430 when the catheter hub 430 is installed in theretainer 120. Referring to FIGS. 11 and 15, when the catheter hub 430 isfully installed in the retainer 120, the push tap 310 extends in adirection away from the central axis 340 of the catheter hub 430 andinto the slot 220. As shown in FIG. 15B, a maximum distance from thecentral axis 340 to a distal end of the push tab 310 is distance T. Withreference to FIG. 11, to allow the push tab of the catheter hub 430 torotate in the region of the mounting wing 210(a), a distance L1 isselected to be equal to or greater than the distance T. The distance L1is measured between the axis of the central channel 140 and the topsurface of the mounting wing 210(a) as shown in FIG. 11. Selecting L1 tobe greater than the distance T permits the push tab 310 to rotate pastthe mounting wing 210(a).

[0122] In contrast, to limit rotation of the catheter hub 430 and pushtab 310 in the region of the mounting wing 210(b), a distance L2 isselected to be less than the distance T. The distance L2 is measuredbetween the axis of the central channel 140 and the top surface of thewall 290 as shown in FIG. 11. Selecting L2 to be equal to or preferablyless than the distance T does not permit the push tab 310 to rotate pastthe mounting wing 210(b).

[0123] An advantage of limiting the rotation of the catheter adapter 430when it is installed in the retainer 120 can be understood withreference back to FIG. 15B. In FIG. 15B, the connector fitting comprisesan elongated body 320 which is attached to the end of a medical line.The other end of the elongated body 320 connects to the catheter adapteror hub 430. The push tab 310 is disposed at a position along the lengthof the body of the hub. A spin nut 330 is disposed around the elongatedbody 320 of the fitting. Internal screw leads within the spin nut 330engage with an external screw thread on the catheter hub 430 in order tosecurely interconnect the connector fitting and the catheter hub 430.

[0124] With reference to FIGS. 5 through 13, since the push tab 310 willcontact the wall 290 of the retainer 120 when the spin nut is rotatedless than 360 degrees, once the push tab 310 contacts the wall 290, thehealthcare provider can connect or disconnect the elongated body fromthe catheter adapter 430 without having to also grip the tab 310. Oncethe healthcare provider rotates the fitting in either direction so thatthe tab 310 contacts the wall 290, the catheter hub 430 is effectivelyimmobilized in that direction such that further rotation of the catheterhub 430 in that direction is prohibited. Once immobilized, thehealthcare provider can unscrew the spin nut 330 or otherwise disengagethe connector fitting from the catheter hub with a single hand. Whilethe use of two hands may be advantageous in certain circumstances whenoperating the spin nut 330, the retainer 120 allows the healthcareprovider to use a single hand.

[0125] Similarly, when connecting or re-connecting the elongated body tothe catheter hub, the healthcare provider can initially rotate the pushtab, via the spin nut, until the push tab contacts the wall 290. Oncethe push tab contacts the wall 290, the catheter hub is immobilizedwhich can enhance further connecting of the elongated body to thecatheter hub. In this way, the healthcare provider can continue to turnthe spin nut until the spin nut is fully engaged with the catheter hubwithout having to grip the push tab or catheter hub.

[0126] The retainer 120 can be used with both luer slip and luer lockconnector fittings. The retainer 120 is designed such that even with thepush tab 310 positioned in the forward most slot 220, the retainer canfit in the space defined between the push tab 310 and the spin nut 330with the spin nut fully engaged. The retainer 120 can be further sizedto closely fit within this space to provide redundancy in arrestinglongitudinal movement of the catheter hub 430 relative to the retainer120. Such slots 220 can also be disposed to extend longitudinally toaccommodate radially extending members of greater longitudinal length,such as the splines of a Kipp-style connector.

[0127] Operation

[0128] An exemplary process for coupling a medical article with thesecurement device described above will now be described with referenceto FIGS. 16 through 18.

[0129] A preferred method of using the preferred embodiment of thesecurement device illustrated in FIGS. 1-13 will be described in thecontext of starting an intravenous line. However, the aspects andfeatures of the operational method and the use of the present securementdevice is not limited to this particular application.

[0130] A heathcare provider preferably begins the procedure by insertingan IV catheter into patient's vein in a known manner and then attachingan intravenous line to the IV catheter though the luer connection. Inparticular, the healthcare provider inserts the tapered or luer end 350of the connector fitting 300 into the catheter hub 430 and then turnsthe spin nut 330 to thread the spin nut 330 over a thread flangedisposed at the distal end of the catheter hub 430. This action drawstogether the two medical article components and releasably interlocksthem. The immediate connection of the IV line to the catheter inhibits aback flow of blood through the catheter. The healthcare provider nowpreferably secures the IV catheter in place on the patient using thesecurement device 100. In some variations of this method, however, thesecurement device 100 can be first be attached to one or both of themedical article (as well as the possibly to the patient) before thehealthcare provider makes the connection between the two medicalarticles.

[0131] In order to illustrate more clearly the interaction between theretainer 120 and the catheter hub 430 in this embodiment, the anchorpads 110(a), 110(b) of the securement device 110 are illustrated asdetached from the retainer 120. In accordance with the preferredembodiment, however, the entire securement device 100 is assembled inaccordance with the above-description (e.g., the mounting wings 210 areattached to the anchor pads) and is sterilized before use.

[0132]FIG. 16 is a perspective view of the connector fitting 300 securedto the catheter hub 430, both aligned with the anchor pad 110(a), 110(b)and the retainer 120. Healthcare provider can secure a medical line 360and the medical articles to a patient using the above-describedsecurement device 100 or a readily apparent modification thereof. Thehealthcare provider aligns the central channel 140 of the retainer 120over the adaptor or catheter hub 430.

[0133]FIG. 17 is a perspective view of the connector fitting 300 securedto the catheter hub 430 with the catheter hub being inserted into theretainer 120. The lower opening 150 in the retainer 120 is pressed overthe catheter hub 430 whereby the catheter hub fitting slides into thecentral channel 140 of the body member 130. Depending on the diameter ofthe catheter hub 430, the retention surface 165 can provide a snap-fitconnection between the hub and the body member 130. The contact surfacesof the catheter hub preferably form one or more radially extendingmembers 310 (e.g., one or more push tabs or annular collars), as shownin the illustrated embodiment. The radially extending member(s) fitsinto one (or more) of the lateral slots 220 in the retainer. As can beseen, the tab 310 of the catheter hub 430 lies within one of the slots220 of the retainer 120. In addition, the body of the catheter hub 430generally lies within the central channel 140 of the retainer. Whenguided through the lower opening 150 by the healthcare provider, thebody of the catheter hub 430 will lie within the central channel 140 ofthe retainer 120. The abutment surfaces of the slot 220 will inhibitlongitudinal migration of the catheter hub 430 through the centralchannel 140 of the retainer 120.

[0134] In addition, if used with a connector fitting 300 in which aportion of the connector fitting, such as the spin nut 330, has agreater radial size than the size of the central channel 140 of theretainer 120, the spin nut 330 can act as a contact surface and willinhibit axial motion in one direction through the central channel 140 ofthe retainer as well. Using the size of the spin nut 330 or otherelement having greater radial size than the size of the channel is notrequired for effective operation of the systems described herein;however, such a technique may be an effective form of securement orredundant securement in some applications.

[0135] The combination of the channel shape 140 (both the truncatedcircular shape and the tapering width), the top of the retainer, and theinterengagement between the slot(s) 220 and the radially extendingmember(s) 310 on the catheter hub 430 arrest movement of the retainedsection of the medical line in three dimension: longitudinally,laterally and transversely. Further, the wall 290 in the illustratedembodiment prohibits the catheter hub from 360-degree rotation while thecatheter hub is installed in the retainer 120. The rotational stopprovided by the wall 290 allows the heathcare provider to attach anddetach the spin nut (and thus the connector fitting) to and front thecatheter hub without having the remove the catheter hub from theretainer. While this feature is preferred in the illustratedapplication, it is optional and the wall 290 can be omitted from thesecurement device, as noted above.

[0136]FIG. 18 is a perspective view of the retainer 120 attached to theanchor pads 110 and securing the catheter hub 430 therein. Once thecatheter hub or other medical article enters the lower opening 150 ofthe retainer 120, the anchor pads 110(a), 110(b) are secured to thepatient. The central channel 140 of the retainer surrounds an arc lengthof more than 180 degrees of the medical article. This inhibits anytransverse or lateral motion of the medical article relative to theretainer 120. The catheter hub can be inserted into the retainer eitherbefore or after the fitting connector is attached to the hub.

[0137] The healthcare provider can first remove one portion of therelease liner 180 from the anchor pad 110 by gripping the pull tab 190and pulling the liner 180 away from the lower surface 160 of the anchorpad 110. This exposes the adhesive layer of the anchor pad, which canthen be applied to the skin of the patient near the site where thehealthcare provider desires to secure the connector fitting 300 or othermedical article. The adhesive layer of the second anchor pad which islocated in a lateral direction from the first anchor pad can besimilarly exposed. The remainder of the release liner 180 for the firstand second anchor pads can then be removed and the anchor pad fullyattached to the skin of the patient. As a variation, the release lineron one anchor pad can be pulled away and the anchor pad can be fullyattached to the patient before attaching the second anchor pad to thepatient.

[0138] Additional Embodiments

[0139] As understood from the above description of the securement deviceembodiment shown in FIGS. 1-13 and 16-18, the securement device 100arrests longitudinal movement of the retained section of the catheterhub 430 by interacting with at least one and preferably two contactsurfaces of the tab 310, which constitutes a radially extending memberin the illustrated embodiment. This approach for arresting longitudinalmovement can also be used with other types of radially extending membersor contacts (e.g., contact surfaces) on the catheter hub 430, theconnector fitting 300 or other medical articles or components thereof.For example, a retainer can be configured to capture or receive a tab,spline (e.g., a longitudinally extending spline) or collar on theconnector-fitting that is disposed on the distal side of the spin nut320, or can capture all or a portion of the spin nut. In otherembodiments, the retainer can be configured to fit between contacts on amedical article or medical articles. For example, the retainer can besized to fit between the spin nut 320 and the hexagonal collar 370 onthe connector fitting 300 or between the proximal side of the spin nut320 and the distal side of the catheter hub tab 310. In such cases, theend surfaces of the retainer function as the abutment surfaces andcooperate with adjacent contacts on the medical article(s).Additionally, the retainer can be configured to not only fit between twocontacts on the medical article(s) but also can be configured to receiveone or more radially extending members of the medical article(s).

[0140] In a variation of this approach, longitudinal movement can alsobe fully arrested (i.e., arrested in both directions along thelongitudinal axis) by (1) the interaction of an abutment on the retainerand a distally facing contact in combination with (2) the shape of thechannel 140. For example, in the previously discussed embodiment, thetapering shape of the channel 140, which decreased in size in theproximal direction, inhibited longitudinal movement toward the insertionsite. The interaction between a proximal side wall of the slot 220 andthe distal side of the catheter hub tab 310 prevents longitudinalmovement in the distal direction. Thus, some embodiments need onlyinclude one abutment. As noted above, the channel can have a taperingshape along at least a portion of its length and a step down in diameteralong its length (as best illustrated in FIG. 14B). The tapering shapecan arrest longitudinal movement in one direction and an abutment, whichis formed at the diameter step down, can interact with a correspondingcontact (e.g., contact surface) on the medical article to arrestlongitudinal movement in the opposite direction.

[0141] Several variations of the retainer design are described below inconnection with FIGS. 19-28. These retainer designs cooperate withcontact points or surfaces on the connector fitting 300 to arrestmovement in the longitudinal direction. Depending on what contact pointsor surfaces are provided on the connector fitting 300, (for example,radially extending members, spin nuts, collars, tabs), one or moreabutments on the retainer will generally abut against one or more of thecontact points or surfaces (as noted above a slight gap can occur insome applications). Additional or redundant abutment points or surfacesmay be provided.

[0142] One embodiment (FIG. 19) illustrates a retainer 120 designed tofit between the spin nut 330 and a hexagonal collar 370 a on theconnector fitting (FIGS. 20 and 21) as shown in FIG. 22. In thisembodiment, the distal and proximal ends of the retainer 120 are theabutment surfaces.

[0143] Additionally, the body member 1300 in this embodiment may or maynot include a groove, slot or other receptacle in the channel 140 forreceiving a ring 1400 or connector tab 310 (FIGS. 20 and 21). Moreover,depending on the radial extent of the ring 1400 or connector tab 310,such a groove, slot, or receptacle may or may not extend through thewall of body member 1300. The retainer previously described withreference to FIGS. 1-13 incorporates such a groove, slot, or receptaclein the form of a slot 220 for engaging with the catheter hub 430 (seeFIG. 18). This slot 220 extends through the wall of the retainer. Toillustrate how a groove, slot, or receptacle in the body member 1300(FIG. 19) would engage with a radially extending member on the connector300, one of the slots 220 in the retainer from FIGS. 1-13 is shown inFIG. 26 as being aligned with a hexagonal nut 1400 on the connector body320. Once installed, the hexagonal nut 1400 can abut against theproximal and distal abutment surfaces of the slot 220. By providing agroove in the channel 140 of the body member 1300, motion of theretainer can be further inhibited by the interaction of the groove withthe ring or tab. Even if a groove(s) is not provided in the retainerillustrated in FIG. 22 and the channel 140 does not fit flush againstthe connector body 320, partial contact between the abutment surfacesand the spin nut 330 and hexagonal collar 370 a can inhibit longitudinalmotion.

[0144] In contrast to the connector fitting embodiments illustrated inFIGS. 20 and 21, the connector fitting illustrated in FIG. 15B does notinclude a radially extending member that is located between the ends ofthe connector fitting 300. The channel 140 of the retainer embodied inFIG. 19 forms an improved fit with the connector fitting illustrated inFIG. 15B as shown in FIG. 23. In FIG. 23, the retainer can generallyabut against the spin nut and the hexagonal collar 370 a to inhibitlongitudinal movement.

[0145] Another embodiment illustrates the retainer 120 being pressedover radially extending members 370 a, 370 b (FIG. 24). Unlike theembodiments described with reference to FIGS. 22 and 23, the length ofthe retainer in FIG. 24 is not selected to fit between distal andproximal contact surfaces on the connector fitting. Instead, the bodymember 1300 in this embodiment includes one or more grooves, slots orother receptacles in the channel 140 for receiving the radiallyextending members 370 a, 370 b. The grooves or slots form abutmentsurfaces that abut against contact surfaces on the radially extendingmembers 370 a, 370 b to inhibit longitudinal motion of the medicalarticle.

[0146] Another embodiment illustrates a retainer 120 designed to fitbetween the spin nut 330 and the hexagonal nut 1400 on the connectorfitting (FIG. 20) as shown in FIG. 25. Unlike the embodiment illustratedin FIG. 22 where a groove or slot in the channel 140 provides a flushfit between the connector body 320 and the retainer, the retainer inFIG. 25 forms a flush fit without a groove or slot. Instead, the shorterlength of the retainer in FIG. 25 allows the retainer to fit between twoadjacent contact points or surfaces. For example, the retainerillustrated in FIG. 25 fits between the spin nut 330 and the hexagonalnut 1400.

[0147] An additional embodiment of a retainer is illustrated in FIGS.27A-J and 28. Only the central channel 1500 of this embodiment differsfrom the above-described embodiment in that the central channelpreferably has a generally constant cross-sectional shape (e.g., agenerally constant diameter to cooperate with a tubular connectorfitting body). In contrast to the retainer designs describe withreference to FIGS. 22 and 26, the constant cross-sectional shape of theretainer design described with reference to FIGS. 27A-J can form animproved fit with the constant diameter of the connector body 320.

[0148] A retainer in accordance with another embodiment of the inventionis illustrated in FIG. 19, with FIG. 19 showing a perspective view of aretainer and anchor pads that are similar to FIG. 1 above. Only the bodymember 1300 of this embodiment differs from the above-describedembodiment. Accordingly, the above description applies equally to theembodiment of FIG. 19, unless otherwise indicated.

[0149] The body member 1300 of the retainer 120 illustrated in FIG. 19preferably is configured to retain a portion of a medical article thathas a generally constant outer radius along its length. (In contrast,the embodiment of the retainer described with reference to FIGS. 1 and16 was sized to retain a tapering portion of the medical article.) Inthe embodiment described with reference to FIG. 19, the inner surface ofthe inverted central channel 140 is sized to match or approximatelymatch the outer radius of the medical article. To arrest longitudinalmotion of the medical article, one or more abutment surfaces on the bodymember 1300 with one or more contacts on the medical article.

[0150] The inner surface of the central channel 140 in the illustratedembodiment has a generally semi-circular cross-sectional shape. Theinner surface contour of the central channel 140 is selected dependingon the diameter or geometry of the portion of the medical article to beretained. For example, since the retainer 120 in FIG. 19 is configuredto retain a portion of a connector fitting that has a constant outerdiameter (see, e.g., the connector fitting illustrated in FIG. 15A), thecentral channel can have a constant radius along its length. By matchingthe inner surface contour of the central channel 140 to the outersurface of the secured portion of the medical article, a more effectivesecurement may be achieved.

[0151] Other embodiments of the retainer 120 can have an inner surfacethat is configured to match, or closely match, an outer surface of araised portion of the connector fitting. Such a raised portion of theconnector fitting can be in the form of two contact surfaces whichtogether form a radially extending member, e.g., an annular collar,ring, or hex nut. By selecting an inside surface contour for theretainer that matches or closely matches the annular member, a form ofsnap-fit can be achieved between the retainer and the connector fittingwhen the connector fitting is engaged with the retainer.

[0152] The annular member and the connector fitting can be manufacturedindividually or as a unitary member. If the inside surface contour ofthe retainer 120 is substantially larger than the outer diameter of theconnector fitting, an annular member can be installed around theconnector fitting to allow a form of snap-fit between the outer diameterof the annular member and the inside surface of the retainer. In such anembodiment, the annular member alone may not inhibit longitudinal motionof the medical article. However, advantageously, the same retainer canbe used with connector fittings with different outer diameters.Moreover, a connector fitting can include more than one annular member.Each annular member can have a different outer diameter whereby theconnector fitting can be used with retainers 120 that have differentinner surface diameters or the same diameter sufficiently sized toreceive the irregularly shaped connector fitting. Additionally, in someforms of the retainer, abutments in the form of, for example, abutmentsurfaces that define, at least in part, a groove are employed to abutagainst one or both of the contact surfaces of the annular member. Byengaging the groove with at least a portion of the annular member,longitudinal motion of the connector fitting relative to the retainercan be inhibited, as described below.

[0153] In addition or in the alternative, effective longitudinalsecurement between the retainer and the connector fitting can also beachieved by the engagement of the radially extending member or annularmember between the retainer and the medical article. The radiallyextending member can be in the form of, for example, an annular collaras previously described. For example, a tab similar to the push tab onthe catheter hub of FIG. 15A could be located on the outer surface ofthe connector fitting. The push tab could engage an abutment surface(s)in the form of a recess or receptacle on the inner surface of theretainer 120. The recess or receptacle in the retainer 120 can be in theform of, for example, a slot or groove. By engaging the push tab withinthe recess, longitudinal movement of the connector fitting with respectto the retainer is further limited. Exemplary radially extending memberswhich can form a snap-fit with the inner surface of the retainer and/orengage a recess or groove in the retainer are described below withreference to FIGS. 21 and 22.

[0154] In addition or in the alternative, the longitudinal length of theretainer 120 can be selected to match, or closely match, thelongitudinal distance between a first contact surface and a secondcontact surface of the connector fitting 320. The first and secondcontact surfaces can be in the form of first and second radiallyextending members that extend from the medical article. For example, thesecond radially extending member could be a spin nut of a catheter hub.For ease of discussion, the longitudinal length of the retainer 120 isillustrated in FIG. 19 as dimension A.

[0155] Connector fittings for use with the embodiment of the retainerillustrated in FIG. 19 are illustrated in FIGS. 20 and 21, with FIG. 20showing a connector fitting and a catheter hub with a ring secured tothe connector fitting, and FIG. 21 illustrating another connectorfitting secured to a catheter hub with a radially extending tab securedto the connector fitting are similar to FIG. 15B above. Only theconnector fitting of these embodiments differs from the above-describedembodiment. Accordingly, the above description applies equally to theembodiments of FIG. 20-21, unless otherwise indicated.

[0156]FIG. 20 is a perspective view of a connector fitting secured to acatheter hub 430, with the connector fitting having two contact surfacesforming a ring 1400. The ring 1400 increases the diameter of theconnector fitting to more closely match the inner surface of theretainer. By increasing the diameter of the connector fitting, the ring1400 and the retainer can form a snap-fit. To arrest longitudinalmovement of the medical article, the connector fitting can includecontact surfaces in the form of a radially extending member 370 a andspun nut 330. The ring 1400 is located between the radially extendingmember 370 a and the spin nut 330. The contact surface on the proximalside of the radially extending member 370 a can abut against an abutmentsurface in the form of a distal end of the retainer. Additionally, thecontact surface on the distal side of the spin nut 330 can abut againstan abutment surface in the form of a proximal end of the retainer. Whenthe connector fitting is inserted into the adapter 430, the lumen of theconnector fitting is disposed in fluid communication with the lumen ofthe adapter 430. This provides fluid communication between the medicalline 360 and the patient.

[0157] The ring 1400 is illustrated as a hex nut located around thecircumference of the elongated body 320 of the connector fitting 300.Alternatively, the ring 1400 can have a circular outer surface similarto the illustrated outside diameter of the spin nut 330. A non-circularshape may be preferred to further inhibit rotational movement of theretainer 120 around the longitudinal axis when the retainer is installedover the connector fitting. The ring 1400 need not have the same shapeas the first or second radially extending members 370 a, 370 b. Forinstance, the ring 1400 can have a circular shape and the first andsecond radially extending members 370 a, 370 b can have the hexagonalshape illustrated.

[0158] The ring 1400 can be fixed to the elongated body 320 or allowedto slide in a longitudinal direction along the elongated body 320. Thoseof skill in the art will recognize that the ring 1400 need not have anyparticular shape or longitudinal thickness. In some applications, asdescribed below in connection with FIG. 22, it may be preferable toincrease the longitudinal length of the ring 1400 (i.e., make the ringthicker) to inhibit the ring from acting as a fulcrum when the connectorfitting is inserted into the retainer illustrated in FIG. 22.

[0159] Alternatively, or in addition to the abutment surfaces describedabove, including one or more abutment surfaces in the inner surface ofthe retainer 120 can further inhibit longitudinal movement. Depending onthe radial dimension of the ring 1400, the abutment surface(s) canextend into or through the wall of the retainer to form a groove orslot, respectively. The groove or slot receives at least a portion ofthe ring 1400. The groove or slot can be sized to either receive thering in a loose or close-fit manner. With the addition of a groove,longitudinal movement of the connector fitting 300 relative to theretainer 120 can still be inhibited by the interaction between the ring1400 and the groove within the central channel 140, especially if thering 1400 fits closely into the groove.

[0160] Additionally or in the alternative to the one or more abutmentsurfaces or to the snap-fit engagement, at least a portion of thecentral channel 140 in all of the illustrated embodiments can be atleast partially coated with an adhesive (e.g., an adhesive thatpreferably releasably holds the fitting within the retainer channel) tolimit or restrict longitudinal movement. Alternatively, the medicalarticle can include an adhesive section to hold the medical article inthe channel and/or relative to the retainer.

[0161] The central channel 140 described with reference to FIG. 19 isconfigured to retain the outer surface of the ring 1400. In this way,the retainer 120 can snap-fit over the ring 1400, thereby retaining themedical article within the retainer. The central channel 140 can have ahexagonal or other non-circular shape to further inhibit rotationalmovement of the connector fitting with respect to the retainer 120.

[0162] As illustrated in FIG. 20, the longitudinal length between thespin nut 330 and the first radially extending member 370 a is dimensionB. With reference to FIGS. 19 and 20, the longitudinal length of theretainer 120, dimension A, can be selected to allow the retainer 120 tofit snugly between and preferably abut the contact surfaces of the firstradially extending member 370 a and the spin nut 330. As noted above, aslight gap can exist between the abutment and contact surfaces; however,a tighter fit will lessen any relative longitudinal movement between theretainer and the connector fitting. In this way, the connector fitting300 will be inhibited from moving in a longitudinal direction relativeto the retainer 120 once the connector fitting 300 is secured within theretainer.

[0163] Alternatively, the longitudinal length of the retainer 120,dimension A, is selected to be less than the distance between the firstradially extending member 370 a and the spin nut 330, dimension B. Withdimension A less than dimension B, the ease by which the connectorfitting is installed into the retainer 120 may be increased.

[0164]FIG. 21 is a perspective view of a connector fitting 300 securedto a catheter hub 430, with the connector fitting having two contactsurfaces forming a tab 310. As briefly described with reference to FIG.20, the tab 310 or ring 1400 can cooperate with a groove or slot 220 inthe retainer to limit longitudinal movement of the medical article wheninstalled in the retainer. In particular, it can be desirable for thelongitudinal length of each slot 220 to be sufficient to receive the tab310 of the medical article. The slot 220 receives the tab 310 from theretained portion of the medical article.

[0165] Combinations of the retainer 1300 with the connector fittingsillustrated in FIGS. 15, 20, and 21 are illustrated in FIGS. 22-25. FIG.22 is an exploded, perspective view of the connector fitting 300 and thecatheter hub 430 of FIG. 20 with the ring 1400 of the connector fittingbeing aligned with the anchor pad and the retainer of FIG. 19. Theinverted channel 140 in the retainer 120 is pressed over the connectorfitting 300 whereby the connector fitting slides into the centralchannel of the body member 1300. The body member 1300 in this embodimentdoes not include grooves, slots or other receptacles for receiving thering 1400. Rather, depending on the outer diameter of the ring 1400, asnap-fit between the ring 1400 and the inner surface of the body member1300 can be formed. In addition, the longitudinal length of the ring1400 (i.e., its thickness) can be selected to inhibit the ring fromacting as a fulcrum point for the retainer 120. Alternatively, or inaddition to, the longitudinal length of the body member 1300, dimensionA, can be selected to fit between the first radially extending member370 a and the spin nut 330, dimension B. As previously described, thespin nut 330 and/or the first radially extending member 370 a can arrestaxial movement in one or two directions of the connector fitting 300when installed in the retainer 120.

[0166]FIG. 23 is an exploded, perspective view of the connector fitting300 and catheter hub 430 of FIG. 15B with the elongated body 320 of theconnector fitting 300 being aligned with the anchor pad and the retainerof FIG. 19. The inverted channel 140 in the retainer 120 is pressed overthe connector fitting 300 whereby the connector fitting slides into thecentral channel of the body member 1300. In the embodiment describedwith reference to FIG. 23, the channel 140 receives the elongated body320 of the connector fitting 300 and is generally configured to house,to preferably grip, and to secure the elongated body 320. The elongatedbody may have a constant outer diameter. In the embodiment illustratedin FIG. 23, the channel 140 is configured to retain an elongated body320 which has a constant outer diameter.

[0167] Alternatively the elongated body may incorporate one or morecontact surfaces in the form of a varying outer diameter or a taperingouter surface. To engage with the tapering outer surface, the channel140 can include one or more abutment surfaces in form of a matchingtapering inner surface along its length. Additional embodiments of thecentral channel 140 of the retainer can comprise a plurality ofdifferent abutment surfaces in the form of radii and/or taperingregions. In this way, the size (i.e., radii, tapered) of the centralchannel 140 can be chosen to match or approximate the size of variousstandard connector fittings, catheter hubs or possibly all or portionsof both. By matching the inner surface contour of the central channel140 to the outer surface of the connector fitting, a more effectivesecurement may be achieved.

[0168] In addition, if the longitudinal length of the retainer 120,shown as dimension A, is selected so that the retainer closely fitsbetween the first radially extending member 370 a and the spin nut 330,dimension B; the spin nut and the radially extending member will furtherinhibit axial motion in one or more directions through the centralchannel 140 of the retainer. Alternatively, if the longitudinal lengthof the retainer 120 is selected to be less than dimension B, the spinnut or the radially extending member will inhibit axial motion in onedirection through the central channel 140. Additionally, the centralchannel can include an adhesive coating that covers at least a portionof the channel to hold the elongated body of the connector fittingrelative to the retainer.

[0169]FIG. 24 is an exploded, perspective view of the connector fitting300 and catheter hub 430 of FIG. 15B with the radially extendingelements 370 a, 370 b of the connector fitting being aligned with ananchor pad and a body member 1300 of the retainer 120. The anchor padand the retainer 120 of this embodiment are configured similar to theanchor pad and the retainer illustrated in FIG. 19; however, the size ofthe central channel differs in each embodiment. In the embodimentillustrated in FIG. 23, the lower channel in the retainer 120 is pressedover the radially extending members 370 a, 370 b whereby the connectorfitting 300 slides into the central channel of the body member 1300. Incontrast to the method of securing the connector fitting 300 to theretainer 120 in FIG. 23, the radially extending members 370 a, 370 bshown in FIG. 24 fit within the central channel 140 of the body member1300. The connector fitting 300 preferably includes one or more contactsurfaces in the form of radially extending members 370 a, 370 b as shownin the illustrated embodiment. The radially extending members 370 a, 370b can provide a snap-fit between the connector fitting 300 and the bodymember 1300. That is, the size and shape of the channel closely matchesthat of the radially extending members 370 a, 370 b. However, theengagement between the connector fitting and the retainer 120 may notarrest longitudinal movement of the medical article.

[0170] Additionally, one or more abutment surfaces in the inner surfaceof the retainer 120 can further inhibit longitudinal movement. Dependingon the radial dimensions of the radially extending members 370 a, 370 b,the abutment surface(s) can extend into or through the wall of theretainer to form a groove or slot, respectively. The groove or slotreceives at least a portion of the radially extending members 370 a, 370b. The groove or slot can be sized to either receive the radiallyextending members 370 a, 370 b in a loose or close-fit manner. With theaddition of a groove, longitudinal movement of the connector fitting 300relative to the retainer 120 can still be inhibited by the interactionbetween the radially extending members 370 a, 370 b and the groovewithin the central channel 140, especially if the radially extendingmembers 370 a, 370 b fits closely into the groove.

[0171] Additionally or in the alternative, at least a portion of thecentral channel 140 can be coated with an adhesive (e.g., an adhesivethat releasably holds the fitting within the retainer channel).

[0172]FIG. 25 is an exploded, perspective view of the connector fitting300 and the catheter hub 430 of FIG. 20 with a portion of the elongatedbody of the connector fitting being aligned with the anchor pad and theretainer of FIG. 19. The central channel 140 in the retainer 120 ispressed over the connector fitting whereby the connector fitting slidesbetween the anchor pads 110(a), 110(b) and into the central channel 140of the body member 1300. As illustrated in FIG. 25, the longitudinallength of the body member 1300, denoted as dimension C, is selected tofit between the spin nut 330 and the ring 1400, dimension D. Thelongitudinal length of the body member 1300 can be selected to closelyfit between the contact surface of the ring 1400 and the contact surfaceof the spin nut 330. In such a configuration, axial movement of theconnector fitting 300 with respect to the retainer 120 can be inhibitedby engagement between the abutment surfaces of the retainer and thecontact surfaces of the connector fitting. Alternatively, the dimensionC is selected to fit between the first radially extending member 370 aand the ring 1400.

[0173] Additional embodiments of the central channel 140 of the retainercan comprise a plurality of different abutment surfaces in the form ofradii and/or tapering regions. In this way, the size (i.e., radii,tapered) of the central channel 140 can be chosen to match orapproximate the size of various standard connector fittings. By matchingthe inner surface contour of the central channel 140 to the outersurface of the connector fitting, a more effective securement may beachieved.

[0174]FIG. 26 is an exploded, perspective view of the connector fitting300 and catheter hub 430 of FIG. 20 with the connector fitting beingaligned with the anchor pad and the retainer of FIG. 1. As shown, theconnector fitting 300 includes two contact surfaces in the form of aring 1400 which fits between two of the abutment surfaces that form oneof the lateral slots 220 in the retainer. In this way, the ring 1400will fit within one of the slots 220, thereby arresting longitudinalmovement of the connector fitting 300 when installed in the retainer120. The slots 220 have a longitudinal length sufficient to accept thering 1400 of the retained medical article.

[0175] The inverted central channel 140 in the retainer 120 is pressedover the connector fitting 300 whereby the connector fitting slidesbetween the anchor pads 110(a), 110(b) and into the central channel ofthe body member 130. When guided through the lower opening 150 by thehealthcare provider, the elongated body of the connector fitting 300will lie within the central channel 140 of the retainer 120. Dependingon the diameter of the ring 1400 and the outer diameter of the connectorfitting, a snap-fit between the ring and the body member 130 can beformed. The abutment surfaces forming the slots 220 will inhibitlongitudinal migration of the connector fitting 300 through the centralchannel 140 of the retainer 120.

[0176] In addition, if the longitudinal length of the retainer 120,shown as dimension A, is selected so that the retainer can fit betweenthe contact surface of the first radially extending member 370 a and thecontact surface of the spin nut 330, dimension B, the spin nut and theradially extending member will further inhibit axial motion in one ormore directions through the central channel 140 of the retainer.Alternatively, if the longitudinal length of the retainer 120 isselected to be less than dimension B, the spin nut or the radiallyextending member will inhibit axial motion in one direction through thecentral channel 140. Such a technique may be an effective form ofadditional securement in some applications.

[0177] The combination of the channel shape (constant radius), theentering engagement between the abutment surfaces and the ring 1400 onthe connector fitting, and the longitudinal length of the body member130 of the retainer 120 arrest movement of the retained section of themedical article in three dimensions: longitudinally, laterally, andtransversely. Further, the wall 290 prohibits the connector fitting from360-degree rotation while the connector fitting is installed in theretainer.

[0178] A retainer in accordance with another embodiment of the inventionis illustrated in FIGS. 27A through 27J that are similar to the retainerdescribed in FIGS. 1-13 and 26 above. Only the central channel 1500 ofthis embodiment differs from the above-described embodiment in that thecentral channel preferably has a generally constant cross-sectionalshape (e.g., a generally constant diameter to cooperate with a tubularconnector fitting body). Accordingly, the above description appliesequally to the embodiment of FIGS. 27A through 27J, unless otherwiseindicated.

[0179] The retainer 120 illustrated in FIGS. 27A-27J includes a body 130that defines a central channel 1500 and a pair of mounting feet 210 a,210 b disposed on opposite sides of the body 130. The opening into thecentral channel 1500 is chamfered to ease insertion of the fittingconnector into the retainer 120. The bottoms of the mounting feet 210 a,210 b generally define a plane and a central axis of the central channel1500 that is skewed relative to the plane, as best seen in FIGS. 27F and27I.

[0180] The body 130 preferably defines at least two abutment surfaces toform one slot 220 and more preferably defines additional abutmentsurfaces to form additional slots 220. The slots 220 are sized to one ormore contact surfaces on the connector fitting. For example, asillustrated in the present embodiment shown in FIG. 27J and 28, eachslot can receive contact surfaces in the form of the hex nut rings 370a, 370 b, 1400, and/or connector tabs 310 that are included on thevarious connector fittings illustrated in FIGS. 15A, 15B, 20, and 21.

[0181] The longitudinal length of the body 130 preferably is sized sothat abutment surfaces located at the proximal and distal ends of theretainer fit closely between the distal contact surface of the spin nut330 and the proximal contact surface of the hex nut ring 370 a when thespin nut is engages with a catheter hub, as illustrated in FIG. 15B. Inthis manner, the retainer body 130 lies between the contact surface ofthe spin nut 330 and the contact surface of the hex nut ring 370 a toinhibit longitudinal movement of the connector fitting (and the attachedcatheter hub) relative to the retainer, which is adapted to be securedto the patient. If, however, the healthcare provider positions theretainer 120 on the connector fitting at a position farther from thespin nut 330, as seen in FIG. 27J, the retainer can still receive theconnector fitting body, as well as one or both of the hex nut rings. Theinteraction between the abutment surfaces of the retainer and thecontact surfaces of the hex nut ring(s) generally arrests longitudinalmovement. In addition or in the alternative to such interaction betweenthe retainer and the hex nut ring(s), the retainer can also include anadhesive coating that covers at least a portion of the central channel1500. The adhesive coating in one preferred form releasably holds theconnector fitting to the retainer to inhibit movement of the connectorfitting relative to the fitting. Such adhesive, in other variations ofthe retainer, can more permanently attach the connector fitting to theretainer.

[0182] The various embodiments of securement devices and techniquesdescribed above thus provide a number of ways to provide safe andreleasable securement for medical articles to the skin of a patient. Inaddition, the techniques described may be broadly applied for use with avariety of medical lines and medical procedures.

[0183] Of course, it is to be understood that not necessarily all suchobjectives or advantages may be achieved in accordance with anyparticular embodiment using the systems described herein. Thus, forexample, those skilled in the art will recognize that the systems may bedeveloped in a manner that achieves or optimizes one advantage or groupof advantages as taught herein without necessarily achieving otherobjectives or advantages as may be taught or suggested herein.

[0184] Furthermore, the skilled artisan will recognize theinterchangeability of various features from different embodiments.Although these techniques and systems have been disclosed in the contextof certain embodiments and examples, it will be understood by thoseskilled in the art that these techniques and systems may be extendedbeyond the specifically disclosed embodiments to other embodimentsand/or uses and obvious modifications and equivalents thereof.Additionally, it is contemplated that various aspects and features ofthe invention described can be practiced separately, combined together,or substituted for one another, and that a variety of combination andsubcombinations of the features and aspects can be made and still fallwithin the scope of the invention. Thus, it is intended that the scopeof the systems disclosed herein disclosed should not be limited by theparticular disclosed embodiments described above.

What is claimed is:
 1. A medical line securement system comprising: amedical article; at least one anchor pad including a lower adhesivesurface configured to attach to an epidermal layer of a patient; and aretainer comprising, a body member having a channel formed therethroughabout a channel axis, the channel being configured to retain at least aportion of the medical article and having a longitudinal access openingdisposed on an underside of the body member to allow at least ingress ofthe portion of the medical article into the channel, at least oneabutment extending generally normal to the channel axis and configuredto inhibit longitudinal movement of the medical article, and at leastone support disposed on the underside of the retainer and to a side ofthe access opening opposite the channel axis, the support attached tothe anchor pad.
 2. A medical line securement system as in claim 1wherein the medical article comprises at least one contact surface whichis configured to abut against the at least one abutment to arrestmovement of the medical article in at least one direction.
 3. A medicalline securement system as in claim 1 wherein the at least one abutmentis located between proximal and distal ends of the body member along theaxis of the channel.
 4. A medical line securement system as in claim 1wherein the at least one abutment is a surface on a proximal end of thebody member along the axis of the channel.
 5. A medical line securementsystem as in claim 1 wherein the at least one abutment is located on adistal end of the body member along the axis of the channel.
 6. Amedical line securement system as in claim 2 wherein the at least onecontact surface comprises a surface of a radially extending member.
 7. Amedical line securement system as in claim 6, wherein the radiallyextending member extends about the circumference of the medical article.8. A medical line securement system as in claim 6, wherein the radiallyextending member extends substantially parallel to the medical article.9. A medical line securement system as in claim 6, wherein the retainercomprises two abutments disposed between the proximal and distal ends ofthe medical article to form a slot therebetween, and wherein the slotreceives the radially extending member when the medical article isinserted into the channel.
 10. A medical line securement system as inclaim 1 wherein the medical article is a catheter hub.
 11. A medicalline securement system as in claim 1 wherein the medical article is aconnector fitting.
 12. A medical line securement system as in claim 1wherein the medical article comprises two contact surfaces, and whereinthe body member of the retainer is sized to fit between the two contactsurfaces.
 13. A medical line securement system as in claim 1 wherein themedical article comprises two contact surfaces and the body member ofthe retainer comprises two abutments, and wherein the two contactsurfaces abut against the two abutments.
 14. A medical line securementsystem as in claim 1, wherein the channel has an arc length of greaterthan 180 degrees.
 15. A medical line securement system as in claim 1,wherein the channel has a first tapering shape.
 16. A medical linesecurement system as in claim 15, wherein an outer surface of themedical article has a second tapering shape.
 17. A medical linesecurement system as in claim 16, wherein the first tapering shape andthe second tapering shape cooperate together when the medical article isinserted into the channel to limit longitudinal movement of the medicalarticle in a first direction.
 18. A medical line securement system as inclaim 17 wherein the medical article comprises a contact surface whichabuts against the at least one abutment to limit longitudinal movementof the medical article in a second direction.
 19. A medical linesecurement system as in claim 1, wherein the retainer comprises aretention surface which is configured to inhibit transverse motion ofthe medical article.
 20. A medical line securement system as in claim19, wherein the retention surface is located in the channel.
 21. Amedical line securement system as in claim 20 wherein the retentionsurface provides a snap-fit securement with the portion of the medicalarticle.
 22. A medical line securement system as in claim 20, whereinthe retention surface flexes when the medical article is inserted intothe channel.
 23. A medical line securement system as in claim 22,wherein the retention surface is a movable wall.
 24. A medical linesecurement system as in claim 20, wherein the channel has a radius of Rand wherein the retention surface is located at a distance of greaterthan R from the axis of the channel.
 25. A medical line securementsystem as in claim 1, wherein the at least one support is a firstmounting wing coupled to the body member and configured to attach to theat least one anchor pad.
 26. A medical line securement system as inclaim 1, wherein the abutment comprises an adhesive, the adhesiveadhering to the medical article when the medical article is insertedinto the retainer.
 27. A medical line securement system as in claim 1,wherein a portion of the body member is transparent to facilitatealignment and ingress when inserting the medical article into thechannel.
 28. A medical line securement system as in claim 9, furthercomprising a stop member which extends into a portion of the slot suchthat when the medical article is inserted into the channel and rotatedin a first direction around the axis of the channel, the radiallyextending member slides within the slot until the radially extendingmember contacts the stop member.
 29. A medical line securement system asin claim 1, wherein the abutment comprises a wall of a slot.
 30. Amedical line securement system as in claim 1, wherein the abutmentcomprises a ridge.
 31. A medical line securement system as in claim 1,wherein the abutment comprises a protuberance.
 32. A retainer configuredfor use with a medical article, the retainer comprising: a body membercomprising, a channel formed through the body member, the channel beingconfigured to retain at least a portion of the medical article andhaving a longitudinal access opening disposed on an underside of thebody member to allow at least ingress of the medical article into thechannel, at least one abutment extending generally normal to an axis ofthe inverted channel and configured to inhibit longitudinal movement ofthe medical article, and at least one support disposed on the undersideof the retainer and to a side of the access opening opposite the channelaxis.
 33. A retainer as in claim 32 wherein the at least one abutment isconfigured to abut against a contact surface on the medical article toarrest movement of the medical article in at least one direction.
 34. Aretainer as in claim 33 wherein the contact surface comprises a surfaceof a radially extending member.
 35. A retainer as in claim 34, whereinthe retainer comprises two abutments to form a slot therebetween, andwherein the slot is configured to receive the radially extending memberwhen the medical article is inserted into the channel.
 36. A retainer asin claim 32, wherein the channel has a tapering shape.
 37. A retainer asin claim 36, wherein the medical article has a tapering shape.
 38. Aretainer as in claim 37, wherein the tapering shape of the channel isselected to match the tapering shape of the medical article to limitlongitudinal movement of the medical article in a first direction whenthe medical article is inserted into the channel.
 39. A retainer as inclaim 38, wherein the at least abutment is configured to abut against acontact surface on the medical article to limit longitudinal movement ofthe medical article in a second direction.
 40. A retainer as in claim32, wherein the retainer comprises a retention surface which isconfigured to inhibit transverse motion of the medical article.
 41. Aretainer as in claim 40, wherein the retention surface is located in thechannel.
 42. A retainer as in claim 32, wherein the at least one supportis a first mounting wing coupled to the body member.
 43. A retainer asin claim 35, further comprising a stop member which extends into aportion of the slot such that when the medical article is inserted intothe channel and rotated in a first direction around the axis of thechannel, the radially extending member slides within the slot until theradially extending member contacts the stop member.
 44. A retainerconfigured for use with a medical article, the retainer comprising: abody member comprising, a channel formed through the body member, thechannel being configured to retain at least a portion of the medicalarticle and having a longitudinal access opening disposed on anunderside of the body member to allow ingress of the portion of themedical article into the channel, at least one abutment extendinggenerally normal to an axis of the channel and configured to inhibitlongitudinal movement of the medical article, and means for holding themedical article away from a patient's skin.
 45. A retainer as in claim44, wherein the means for holding is located in the channel.
 46. Aretainer as in claim 44, wherein the means for holding is located to theunderside of the retainer.
 47. A retainer as in claim 44, wherein themeans for holding also inhibits motion of the medical article in alongitudinal direction.
 48. A retainer as in claim 44, wherein the meansfor holding also inhibits motion of the medical article in a transversedirection.
 49. A retainer configured for use with a medical article thatcomprises a radially extending member, the retainer comprising: a bodymember having proximal and distal ends and further comprising, a channelformed through the body member, the channel being configured to retainat least a portion of the medical article and having a longitudinalaccess opening disposed on an underside of the body member to allow atleast ingress of the medical article into the channel, at least one slotdisposed between the proximal and distal ends of the body member andconfigured to receive the radially extending member, and a stop memberextending into a portion of the at least one slot such that when themedical article is inserted into the channel and rotated in a firstdirection around the axis of the channel, the radially extending memberslides within the slot until the radially extending member contacts thestop member.
 50. A retainer as in claim 49, wherein the body memberfurther comprises at least one support disposed on the underside of theretainer and to a side of the access opening opposite the channel axis.51. A retainer in claim 50, wherein the retainer comprises a retentionsurface which is configured to inhibit transverse motion of the medicalarticle.
 52. A method of securing a medical article to a patient, themethod comprising: providing a medical article; providing a retainerhaving a channel formed therethrough, the channel being configured toreceive and retain the medical article, and at least one abutmentextending generally normal to the channel; positioning the retainer overthe medical article; pressing the medical article into the channelthrough an opening formed on the underside of the retainer; abutting themedical article against the abutment to inhibit longitudinal motion ofthe medical article relative to the retainer in at least one direction;and after pressing the article into the body member, adhering theretainer relative to a patient's skin.
 53. A medical line securementsystem comprising: a medical article having a connector; a retainercomprising, a body member having a channel formed therethrough, thechannel being configured to retain at least a portion of the medicalarticle and having a longitudinal access opening disposed on anunderside of the body member to allow ingress of the portion of themedical article into the channel, at least one abutment extendinggenerally normal to an axis of the channel and configured to inhibitlongitudinal movement of the medical article, at least one supportsurface disposed on the underside of the retainer and to a side of theaccess opening opposite the channel axis, wherein an overall length ofthe retainer is less than a length of the medical article.
 54. A medicalline securement system as in claim 53, wherein the retainer furthercomprises at least one anchor pad including a lower adhesive surfaceconfigured to attach to an epidermal layer of a patient; and wherein theat least one support surface is configured to attach to one of the atleast one anchor pads.
 55. A medical line securement system as in claim53, wherein the medical article is a catheter hub.
 56. A medical linesecurement system as in claim 53, wherein the medical article is aconnector fitting.
 57. A medical line securement system as in claim 53,wherein the medical article comprises at least one contact surface whichis configured to abut against the at least one abutment to arrestmovement of the medical article in at least one direction.
 58. Aretainer configured for use with a medical article, the retainercomprising: a body member comprising, a channel formed therethrough, thechannel being configured to retain a portion of the medical article andhaving a longitudinal access opening disposed on an underside of thebody member to allow ingress of the medical article into the channel, atleast one abutment extending generally normal to an axis of the channeland configured to inhibit longitudinal movement of the medical article,and at least one support disposed on the underside of the retainer andto a side of the access opening opposite the channel axis, wherein adistance between the at least one support and the axis of the channelprevents contact between the medical article and a patient's skin whenthe retainer is placed upon the patient's skin.
 59. A retainer as claim58, wherein the channel comprises at least two portions that are spacedapart with the at least one abutment in between, each portion extendingabout the channel.
 60. A retainer configured for use with a medicalarticle, the retainer comprising: a body member comprising, a channelformed therethrough, the channel being configured to retain the medicalarticle and having a longitudinal access opening disposed on anunderside of the body member to allow ingress of the medical article, atleast one abutment extending generally normal to an axis of the channeland configured to inhibit longitudinal movement of the medical article,at least one support disposed on the underside of the retainer and toone side of the access opening opposite the channel axis, wherein thesupport surface provides a mounting surface for attachment of theretainer to a patient's skin, and wherein the mounting surface is angledrelative to the longitudinal access opening to define an incident anglebetween the axis of the channel and the patient's skin.